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• <br />-~- <br />Certification• <br />As an authorized representative of the applicant, I hereby certify that the operation <br />described has met the minimum requirements of the following terms and conditions: <br />1. To the best of my knowledge, all significant, valuable and permanent man-made <br />structure(s) in existence at the time this application is filed, and located within 200 <br />feet of the proposed affected area have been identified in this application (Section 34- <br />32.5-115(9)(e), C.R.S.). <br />2. No mining operation will be located on lands where such operations are prohibited by <br />law (Section 39-32.5-115(4)(f), C.R.S.; <br />3. As the applicant/operator, I do not have any extraction/exploration operations in the <br />State of Colorado currently in violation of the provisions of the Colorado Land <br />Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.) <br />as determined through a Board finding. <br />9. I understand that statements in the application are being made under penalty of <br />perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br />pursuant to Section 18-8-503, C.R.S. <br />Signed and dated this 23 day of ~2, t' Q1~ ~{L <br />~~E7~I~~Ll7 LLG <br />Applicant/Operator or Company Name <br />Signed: <br />Title: ~LN.~e{~ ~~'YI[L~taGC/ <br />If Corporation Attest (Seal) <br />Signed: <br />Corporate Secretary or Equivalent <br />Town/City/County Clerk <br />State of Cd ~1dQ-dL0 ) <br />/ /'• .[ - ) s s <br />County of nk PG~~ ) <br />The foregoing instrument was acknowledged before me this ~ day of ~2 ~!~u al~T, !~ g9, <br />by ~ ~^~6 NQ as ~!~~llV)dvi(l(.~L~(/ of ,~GOZI~~OL1O,u,L <br />~~"ooKlMMry"i <br />_`i~f~O~`•~'''s ~ No~c <br />~.,~.puau~oo Ja,.~e z3~~ <br />'/~"~q,~0iiC01 ~QP~~.` My Commission expires: <br />'"~ COMMISSION EXPIRES' <br />DUNE 23, 2007 <br />S IC8971TQI2ES !LUST SE IN BLUE INlC <br />04/25/97 2823FC0.112 <br />